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Correlation of transcranial doppler (TCD) parameters with jugular bulb venous oxygen saturation (SjO2)

Introduction

Disturbances of the cerebral circulation play a key role in the pathophysiology of head injury. TCD ultrasonography, a non invasive bedside technique, and SjO2 monitoring, an invasive technique which has some risk factors, are methods of assessing cerebral hemodynamics. The purpose of the study was to examine the relationships between TCD parameters and SjO2 measurements in patients with head injury.

Methods and materials

Forty patients (35 ± 18 years) with severe head injury (Glasgow coma scale < 8) were included in the study. All patients were mechanically ventilated, sedated and paralyzed. Continuous monitoring of intracranial pressure (ICP), arterial pressure, pulse oximetry and SjO2 were performed in every patient. Multiple TCD examinations (total 150) were performed during the first five ICU days. The TCD parameters were: maximum velocity (Vmax), minimum velocity (Vmin), and pulsatility index (PI). The findings from TCD were compared with SjO2 values using the method of Pearson's product moment coefficient of correlation and linear regression analysis.

Results

Among TCD parameters PI was found to be correlated with SjO2. There was a leak correlation between PI and SjO2, for SjO2 values below 75% (r = -0.51, P < 0.01). A breakpoint SjO2 value of 75% was demonstrated above which there was no correlation between PI and SjO2 (r = -0.59, P > 0.05). With the same method Vmax and Vmin were unable to provide more information.

Conclusion

The pulsatility index (PI) cannot predict changes of SjO2 values. Therefore a combination of TCD and SjO2 monitoring can provide better access to cerebral hemodynamics.

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Voulgaris, S., Partheni, M., Vrettos, T. et al. Correlation of transcranial doppler (TCD) parameters with jugular bulb venous oxygen saturation (SjO2). Crit Care 6, P62 (2002). https://doi.org/10.1186/cc1764

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Keywords

  • Head Injury
  • Intracranial Pressure
  • Glasgow Coma Scale
  • Pulse Oximetry
  • Invasive Technique